Presentation on theme: "International Strategies for Strengthening Midwifery"— Presentation transcript:
1 International Strategies for Strengthening Midwifery International Confederation of MidwivesInternational Strategies for Strengthening MidwiferyFrances Ganges, MPH, CNMBOD- Americas Regional RepStrengthening Midwifery Globally
2 The sole voice representing midwives globally International Confederation of MidwivesThe sole voice representing midwives globallyUmbrella organization of professional midwifery associations108 member associations250,000 midwives98 countries4 regionsAfricaAmericasAsiaEuropeStrengthening Midwifery Globally
3 ICM Americas Region North America Caribbean Latin America USA, CanadaCaribbeanLatin AmericaBOD Regional Representatives:Mirian Solis – Latin AmericaFrances Ganges – N. America/Caribbean
4 International Confederation of Midwives Strengthening Midwifery Globally
5 ICM History 1919: International Midwives Union International Confederation of MidwivesICM History1919: International Midwives Union1934: International Federation of Midwives1954: International Confederation of MidwivesStrengthening Midwifery Globally
6 Midwives Associations International Confederation of MidwivesMidwives AssociationsSwedish Association of Midwives: 1711(!)Royal College of Midwives: 1881Ghana Registered Midwives Society: 1932American College of Nurse Midwives: 1955Trinidad and Tobago Association of Midwives: 1995Caribbean Midwifery Initiative: 2012Strengthening Midwifery Globally
7 International Confederation of Midwives Strengthening Midwifery Globally
8 International Confederation of Midwives Strengthening Midwifery Globally
9 Strengthening and promoting the profession International Confederation of MidwivesStrengthening and promoting the professionFocus of global effortsGlobal standards and tools (education, regulation, competencies) produced to define scope of practice and guide governmentsStrengthening midwives associations - to promote autonomy and ability to advocate and lobby governments. To aggregate midwives‘ efforts and influence policyAdvocacy –raising the profile of midwives--Positioning and professionalizing midwifery and midwives for visibility and impactTwinning – to disseminate expertise and knowledge among midwives across national boundariesStrengthening Midwifery Globally
10 International Confederation of Midwives ICM global partnersInternational Federation of Gynecologists and Obstetricians (FIGO)International Pediatric Association (IPA)International Council of Nurses (ICN)World Health Organization (WHO)United Nations Population Fund (UNFPA)White Ribbon Alliance for Safe Motherhood (WRA)Strengthening Midwifery Globally
11 Millennium development goals International Confederation of MidwivesMillennium development goalsStrengthening Midwifery Globally
12 Midwifery: a critical workforce for achieving MDGs 4,5 & 6 International Confederation of MidwivesMidwifery: a critical workforce for achieving MDGs 4,5 & 6Making sure women throughout the world can give birth… in the presence of a midwife, is the best strategy for substantially reducing maternal mortality worldwide....Lancet Maternal Survival Series 2005The world needs midwives now more than everStrengthening Midwifery Globally
13 Challenges and Issues Acute shortage of midwives International Confederation of MidwivesChallenges and IssuesAcute shortage of midwives350,000 neededNumber of trained midwives do not meet needsDiversity in midwifery definition and trainingScope of practice inadequateConstraints on the role of the midwife in midwifery regulationPrescriptive authority lackingLack of regulatory frameworkStrengthening Midwifery Globally
14 ICM Council Decisions 2008Update existing & develop new core documentsWork to be accomplished became known as the “Three Pillars” of ICM’s global efforts to strengthen midwifery worldwidePillars include education based on updated core competencies, regulation, and strong Member Associations.
15 3 Pillars of ICM Provides practice standards International Confederation of Midwives3 Pillars of ICMProvides practice standardsDefines & protects scope of practiceProvides a highly qualified workforceProvides professional supportContributes to policy developmentSupports relationships with other health care professionsStrengthening Midwifery Globally
16 Why ICM Standards. ICM represents the world’s midwives Why ICM Standards? ICM represents the world’s midwives. ICM has goal to strengthen midwifery worldwide. Need global consensus on how one educates a fully qualified midwife*. *Persons educated and trained to competency in all the ICM basic or core competencies, legally recognized to practice full scope midwifery, and who maintain competency over time.
17 Need for Education Standards Many individuals use ‘title’ midwifeEducation varies as does qualityScope of practice & practice competencies varyMany countries needing midwives do not have a midwifery education program
18 Purpose of Education Standards Set quality indicators based on global norms/expectationsStandardize core elements of basic preparationEncourage flexibility in curricular design & contentProvide framework for:DesignImplementation, andEvaluation of ongoing quality of programAlign scope of midwifery practice with regulatory bodyEstablish ‘trust’ between employers & programsProvide credibility of graduatesHold midwifery program accountable to public
19 The Process ICM Board appointed Education Task Force Co-Chairs 1/2009 J. Thompson & A. Sawyer11 additional members confirmed 4/2009All ICM regions, 3 official language groups, WHO rep.Member of ICM Board & Education Standing CommitteeReviewed existing literature & standards availableDrafted Preface, Standards, & Glossary 5/2009IRB approval for international modified Delphi study 8/2009Agreed need for Companion GuidelinesHow to implement the standardHow to determine if standard is met
21 Key Documents Reviewed Core ICM documents & position statementsWHO Midwifery Modules & Midwifery Toolkit (draft)WHO Global standards for the initial education of professional nurses and midwives (2009)Accreditation Commission for Midwifery Education (2008) – USAEast, Central, & Southern Africa Council on Nursing (ECSACON): Professional nursing and midwifery standardsEuropean Union and United Kingdom midwifery standardsTF members country/regional standards for midwifery education
22 Research QuestionWhat are the elements of quality that should be reflected in any type of midwifery education programme that prepares a person to meet the ICM International definition of the midwife & ICM Essential competencies for basic midwifery practice ?
23 Study Methodology Modified Delphi survey process Internal (1) round External (2) global roundsConsensus at .80 (80%) level or aboveTwo-phase process over two years (May through December 2010)Phase 1: development of survey instruments, human subjects research approval – May to September/2009Phase 2: validation of standards, revising as needed after each round with diverse panel of stakeholders
24 Country Responses by ICM Region Africa 10/20 countries = 50% Americas 9/14 countries = 64% (plus 3 non-ICM member countries) Asia Pacific 8/18 countries = 44% Europe 19/36 countries = 53% Overall response rate to electronic survey = 52% (46/88)
25 ICM Global Standards For Midwifery Education (2010) Final DocumentPreface, Glossary, Standards and Guidelinespost-secondary level of education to begin program3 years minimum direct entry18 months minimum post-health professionalFramework for Standards: I. Organisation and administration (6) II. Midwifery faculty (8 plus 8 subparts) III. Student body (6 plus 8 subparts) IV. Curriculum (6 plus 4 subparts) V. Resources, facilities and services (5 plus 5 subparts) VI. Assessment strategies (5 plus 5 subparts)
26 Approval Process Standards Final drafts sent to ICM Board in November 2010ICM Board approved the Standards December 16, 2010, including glossary of terms usedICM Board approved the revised Preface in January 2011ICM Board endorsed the developing Companion Guidelines 2010Spanish & French translations completed March 2011Documents placed on ICM website April 2011ICM Council overwhelmingly endorsed standards in June 2011
27 Caveats These are minimum standards = adaptability Any country/program can exceed standards based on country philosophy & needsAny country/program can exceed basic ICM essential competencies based on priorities, needsAny country/program must exceed minimum length if have other non-midwifery content includedAny country/program can add more midwifery content – extend length
28 ICM Global Standards for Midwifery Education (2010) with Guidelines The steps ahead….Raise awareness about these EducationStandards and Companion GuidelinesDiscuss and develop processes for the Implementation of the Education Standards in selected countriesSupport Implementation of the Standards by working with partners and provision of adequate quality education material and expert support
29 International Confederation of Midwives The Midwife effectI found – and it was not a finding I had expected – that wherever (there was) a system of maternal care based on trained and respected midwives maternal mortality was at its lowest.I cannot think of an exception to that rule(Loudon 1992)Strengthening Midwifery Globally
30 Americas Regional Midwifery Conference International Confederation of MidwivesAmericas Regional Midwifery ConferenceQuito, EcuadorMay 2013Strengthening Midwifery Globally
31 30th ICM Triennial Congress International Confederation of Midwives30th ICM Triennial CongressJune, 2014See you there…Strengthening Midwifery Globally
32 Thank You! International Confederation of Midwives Laan van Meerdervoort AN, The HagueNetherlandsTelephone: +31 (0)Fax: +31 (0)Strengthening Midwifery Globally
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